Article
Author: Gershenwald, J. E. ; Amaria, R. N. ; Szczepaniak Sloane, R. ; Daniel, C. R. ; Ajami, N. J. ; Chen, P. L. ; Hoffman, K. ; Shelburne, S. ; Hwu, W. J. ; Vence, L. M. ; Haydu, L. E. ; Rezvani, K. ; Tsujikawa, T. ; Woodman, S. E. ; Sirmans, E. ; Petrosino, J. F. ; Jiang, H. ; Hutchinson, D. S. ; Hudgens, C. W. ; Hu, J. ; Le Chatelier, E. ; Chen, W. S. ; Cogdill, A. P. ; McAllister, F. ; Patel, S. P. ; Marcelo Riquelme Sanchez, E. ; Austin-Breneman, J. L. ; Swennes, A. G. ; Allison, J. P. ; Gardner, J. M. ; Pons, N. ; Chemaly, R. F. ; Prieto, P. A. ; Hwu, P. ; Zhang, J. ; Futreal, P. A. ; Diab, A. ; Okhuysen, P. C. ; Jensen, V. B. ; Cooper, Z. A. ; Spencer, C. N. ; Davies, M. A. ; Lazar, A. J. ; Andrews, M. C. ; Wei, S. C. ; Lee, J. E. ; Jenq, R. R. ; Nezi, L. ; Shpall, E. J. ; Sharma, P. ; Tawbi, H. ; Reddy, S. M. ; Vicente, D. ; Cotechini, T. ; Reuben, A. ; Galloway-Pena, J. ; Gopalakrishnan, V. ; Tetzlaff, M. T. ; Zitvogel, L. ; Zhao, L. ; Glitza, I. C. ; Coussens, L. M. ; Alousi, A. M. ; Wargo, J. A. ; Petaccia de Macedo, M. ; Kumar, T. ; Karpinets, T. V. ; Zhang, Y. ; Burton, E. M. ; Manzo, T.
Preclinical mouse models suggest that the gut microbiome modulates tumor response to checkpoint blockade immunotherapy; however, this has not been well-characterized in human cancer patients. Here we examined the oral and gut microbiome of melanoma patients undergoing anti-programmed cell death 1 protein (PD-1) immunotherapy (n = 112). Significant differences were observed in the diversity and composition of the patient gut microbiome of responders versus nonresponders. Analysis of patient fecal microbiome samples (n = 43, 30 responders, 13 nonresponders) showed significantly higher alpha diversity (P < 0.01) and relative abundance of bacteria of the Ruminococcaceae family (P < 0.01) in responding patients. Metagenomic studies revealed functional differences in gut bacteria in responders, including enrichment of anabolic pathways. Immune profiling suggested enhanced systemic and antitumor immunity in responding patients with a favorable gut microbiome as well as in germ-free mice receiving fecal transplants from responding patients. Together, these data have important implications for the treatment of melanoma patients with immune checkpoint inhibitors.